Untapped Potential: Performance of Procedural Skills in the Family Medicine Clerkship

Abstract

Background and objectives: While family medicine residency directors have expressed concern about low procedural skills proficiency among incoming residents, curricular recommendations do not provide widely accepted guidance. This study was designed to describe requirements and experiences in procedural skill training during the family medicine clerkship and test the hypothesis that more rural placements may support this training.

Methods: The survey was conducted as part of the CAFM Educational Research Alliance (CERA) Family Medicine Clerkship Director (CD) 2013 survey. All Liaison Committee on Medical Education (LCME)-accredited medical schools in the US and Canada with a family medicine educator as family medicine or primary care CD were surveyed. CDs answered questions about clerkship structure and procedure experience and requirements for students. Choosing from a list of procedures, respondents detailed how often students perform specific skills during a rotation.

Results: The response rate was 73% (94 out of 129). Thirty-six procedures were performed during the family medicine clerkship. Of the procedures performed at least once, the most common were Pap test (57.1%), vaginal swab (42.9%), ECG recording (41.9%), urinalysis (40.0%), and throat swab (39.0%). Of the procedures performed more than three times, the most common were Pap test (21.0%) and sterile technique (20.0%). Learners in rural rotations were more likely to perform a range of procedures.

Conclusions: Though exposed to a wide range of procedures during the family medicine clerkship, students did not often repeat procedures. Creation of a core list of procedures and taking better advantage of rural placements may improve procedural skill training in the family medicine clerkship.